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Matt Coles

Matt Coles

Posted: April 16, 2010 02:05 PM

The President and Hospital Visitation

What's Your Reaction:

Early in 1978, I hung out a shingle and began practicing law with three friends on Castro Street in San Francisco. It was before HIV turned all our lives upside down, but we soon realized that hospital ICU visitation policies were a big problem for the LGBT community. So many lesbians and gay men in those days had come to San Francisco because life elsewhere was impossible. They'd built families because they were rejected by their "natural" families. But most medical facilities didn't recognize those families.

My law partners and I sat down and created a very official sounding document called a "Hospital Visit Authorization." It purported to direct the hospital to let a person named by the patient visit if visiting were restricted. We also tried to create a medical power of attorney so partners could make medical decisions. We didn't have any legal authority for any of this. We just made the stuff up. And more times than I care to remember, I bluffed my way through confrontational phone calls with hospital administrators and lawyers. I'm pretty proud of the fact that most of the time I got them to back down.

But in the ensuing 30 years (ok, 30 plus years), the problem didn't go away. In the first Domestic Partnership laws, hospital visiting was something we always included. Just three years ago, a story we used in a video about a man whose partner died alone because of a hospital visitation policy broke my heart.

Maybe that history is why I got a genuine all-American lump in my throat when I read President Obama's Memo to Kathleen Sebelius on Hospital Patients yesterday. I'm still a geeky lawyer at heart, so I loved the substance of the memo. The President told Sebelius to use her power to make rules for hospitals that get Medicaid and Medicare--virtually all hospitals. So it isn't a classic regulation; if you don't want to comply, you don't have to. You just can't get paid by Medicare if you don't. Cute. Moreover, by doing that, the President was using the federal power to spend--the broadest of the federal government's powers

But it was the President's explanation of why we needed the new policy that got me misty:

There are few moments in our lives that call for greater compassion and companionship than when a loved one is admitted to the hospital. In these hours of need and moments of pain and anxiety, all of us would hope to have a hand to hold, a shoulder on which to lean -- a loved one to be there for us, as we would be there for them.

Yes. Exactly. He went on:

Yet every day, all across America, patients are denied the kindnesses and caring of a loved one at their sides -- whether in a sudden medical emergency or a prolonged hospital stay... Also uniquely affected are gay and lesbian Americans who are often barred from the bedsides of the partners with whom they may have spent decades of their lives -- unable to be there for the person they love, and unable to act as a legal surrogate if their partner is incapacitated.

I felt like the man had been there with me in the early 80s when we were trying to get partners into ICUs with people who had GRIDS (the first name for what we now call AIDS). Did I mind that he talked about straight widows or nuns? Not at all. I want him not just to issue orders but to make Americans understand. And this memo works hard to do that.

As I walked home after reading the memo, I realized that after this order, those "Hospital Visit Authorizations" and local domestic partnership laws will soon not just be unnecessary. They'll soon be forgotten, not even a historical footnote. So I went home and poured myself a small glass of old whiskey (ok, not that small) to celebrate the irrelevance of something I worked hard on when I was a young lawyer. How sweet it is to become beside the point.

 

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HUFFPOST SUPER USER
momcat54
04:25 PM on 04/18/2010
It is sad that it takes a Presidential order to make people do the right thing. Many years ago Lyndon Johnson had to do something very similar over segregation , only in typical Lyndon fashion he just made a phone call , I niss Lyndon, he was crude , he was a conivor but he could get things done
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Rosanneofpgh
some days youre the dog;others the hydrant
06:04 PM on 04/18/2010
Ive been missing LBJ, too. He was the most effective majority leader in modern history. Granted, he was crude and even boorish at times, but he could keep the senate in line as nobody else has been able to do since then.
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HUFFPOST SUPER USER
momcat54
08:59 PM on 04/18/2010
He went to school with my grandmother and they were lifelong corespondents. He was an interesting man to say the very least. and a hell of a dancer
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HUFFPOST SUPER USER
glockman
09:39 AM on 04/18/2010
I felt no such lump in my throat. This is certainly the correct thing to do. And I hope the president goes further and pushes for legislation recognizing gay marriage. And I hope he gets the repeal of DADT rolling.

But don't start gushing on about how wonderful Pres. Obama is just yet, people. Keep a critical eye open. He is also doing some things that are criminal and unconstitutional. A good push for humanity doesn't excuse a terrible decision against it.
01:50 AM on 04/18/2010
It was the right thing to do...and, this President is the right man at the right time.
02:49 PM on 04/18/2010
So why wasn't this signed 14 months ago????

This was only signed because midterms are coming up.
The dems need the gay dollars.
Nothing else of substance will be accomplished on gay rights this year.
Obummer won't do anything for gay people unless he's absolutely pushed.
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Soulmentor
"To thine own self be true...."
03:55 PM on 04/18/2010
You aren't seeing the forest for the trees. You can bet this is part of an Obama long term strategy for gay civil rights and he's had this in his head waiting for the most opportune time to make it happen. Sure, it's timed for the mid-terms, but why not? It was also precisely the right moment to do it when, after a big legislative win and political bump he could spend a bit of that political capital when the general public is carrying on about other things and not noticing this so much. Even the T-Partiers seem to be missing it and the obstructionist Rethugs haven't uttered a peep.
He got it in "under the radar" and you're being a cynic about it. Cut the man some slack. So far, he's the best President "we" have ever had in our corner.
Sure, keep the pressure on, but carefully. Cynicism is not helpful.
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Freesia2
I'm nicer than I appear in print. :-)
10:38 AM on 04/17/2010
Lovely article, Matt.

His way of putting the order through put me in mind of some maneuvers FDR used. I'm not a lawyer and I can't remember the particulars (and I'm just now working on my first cup of coffee - searching the net would be like asking me to run a marathon just now. :-) ) but Roosevelt as I recall did something where "of course you can have a federal contract - as long as you don't discriminate. If you do, then good luck to ya. Next."

How wonderful when tired old things go the way of the horse and buggy and progress is made. Especially something like this. If you've ever sat in hospital room with someone terrified, possibly dying, and knowing when they open their eyes they will find you there, that you are there for them to reach for and you can reach for them....well then you know what this means. It's medicine and it's peace. And you don't have to be gay, I'm not, to know it and to want that for everyone.

Our President did well here and I'm so happy for everyone who will benefit. Raising my coffee to your whiskey and toasting.
09:48 AM on 04/17/2010
Dignity in life, dignity in sickness, and dignity in death.

Just as LBJs Medicare memo ended the "white hospital v. negro hospitals", this order essentially ends the unnecessary and arbitrary rules of visitation.

Salute to Mr. Obama - your dignity and class are on full display.
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Freesia2
I'm nicer than I appear in print. :-)
10:39 AM on 04/17/2010
I love my President.
HUFFPOST SUPER USER
bigfated
No one speaks English and everything's broken...
02:20 AM on 04/18/2010
Freesia2: So do I. How wonderful to have a president with a heart and soul......not to mention infinite patience and amazing intellect. How lucky we are....and how sad for those who have allowed themselves to become Obama haters. The He&^ with the Tea Partiers. I'm just gonna enjoy Obama's time in the Oval Office.....and pray for his safety.
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HUFFPOST SUPER USER
glockman
09:33 AM on 04/18/2010
Then pay attention to everything he does. This is the right thing, but assassinating American citizens without due process is not.
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HUFFPOST SUPER USER
jcwtts1
Elections have consequences
09:06 AM on 04/17/2010
I'll just say this, Obama gets it. It is why I elected him. Is he perfect, of course not, but he gets it. As someone who had a mother die of cancer I know all about the ICU all about the strict rules. I'll just say this. Obama lost his mother to cancer and she had to have had extended stays in the hospital. He gets it because he lived it and he acted to right an institutional wrong. I have ICU horror stories galore, but I look just like my mom, no one ever questioned me. But think how it went with a black kid trying to get in to see his white mother. How often did they tell him no? How often did they say, no to the asian daughter? Seriously. Think about it.

J
06:47 AM on 04/17/2010
So it only took 14 months for Obama to do the right thing and sign a memo.

Yep. That sure is some "fierce advocating"

Weak Broth!
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HUFFPOST SUPER USER
jcwtts1
Elections have consequences
09:01 AM on 04/17/2010
I guess you didn't read the above blog but hey. You're part of the reason we can't pass repeal but hey. Keep on keepin on.

J
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04:13 AM on 04/17/2010
This story should have made it to the top of the Politics home page.

Democracy at its best...this is what America is missing right now empathy and courage.

We all want to be loved, and I personally do not care with whom one finds that love,
sometimes its all the medicine we need to feel better.

I've seen this happen between a couple who had been with each other for 13 years
and the family of the dieing patient refused to allow her partner access. It was
heartbreaking.
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03:59 AM on 04/17/2010
This story should have made it to the top of the Politics home page, thankyou Matt.

This is democracy at its best...this is what America is missing right now empathy and courage.

We all want to be loved, and I personally do not care with whom one finds that love,
sometimes its all the medicine we need to feel better.

I've seen this happen between a couple who had been with each other for 13 years
and the family of the dieing patient refused to allow her partner access. It was
heartbreaking.
This user has chosen to opt out of the Badges program
04:20 AM on 04/17/2010
Oooops, sorry guys for the double post, it just takes so long when pending you begin to think you've been hung out to dry.
HUFFPOST SUPER USER
backekuchen
03:39 AM on 04/17/2010
Amen!
jjtx
We need to look for the Third Way.
12:14 AM on 04/17/2010
The President continues to make me proud.

7. His compassion for all people evident in this memo - to include all the loved ones in the care of a hosptal patient.

I could not be prouder of the POTUS. He is all I was hoping he would be.

He works harder than any president in recent memory and he is doing so many positive things I might not be able to list them all. Here's a start:
1. moving toward health care for all Americans - too bad the public option failed, maybe next time
2. working on a common-sense regulation of the big banks - they do need to pay for their own failures
3. start of a sane energy policy - instituting credits for the right choice of energy use is a start as well as provisions for alternative transportation - could be bolder but bolder could not have passed - but, finally, a president that will address the issue of energy use
4. working toward an international agreement to stop nuclear proliferation - the recent summit has me beaming
5. more to follow

WOW! What a man we have as president. Let's support and work for and with him.

6. the economy is turning around from the shambles it was left in by Bush - what an inheritance, huh -- 2 used wars and a pending depression
HUFFPOST SUPER USER
bigfated
No one speaks English and everything's broken...
02:22 AM on 04/18/2010
JITX.....AMEN!
11:45 PM on 04/16/2010
This President , I am reminded yet again, is everyones president - and some of us are prouder, happier and more thankful for that fact than others. Some - a minority - are disdainful of everything this president does and every word he utters. They continue to lie, dissemble, ignore or distort the facts, misrepresent them or blatantly twist them to their own selfish purpose in their zeal to try to "bring him down." They know who "they" are.
And then there is the rest of us, who see in President Obama a man of principle, courage, and vigorous leadership; a man who has a core of values that are shared by most Americans; a man willing to make the tough calls that irritate the left and send the the "seccessinist righties" howling and screaming to the nearest Tea Party. But in these smaller actions, as well as the "big issues" actions, he is proving to be thoughtful, judicious, and compassionate. On further reflection, one could say indeed, that his moral core is attuned to the fact that the universe does indeed bend toward the arc of justice. All this, I am recognizing daily, is an integral part of just who is this man we Americans elected as our 44th President 18 months ago. Thank God we did!
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goodpyr
animated snowdrift
01:31 AM on 04/17/2010
Lewinaz:You express yourself well.I'm just the first in a long line to come. Fanned!
10:48 PM on 04/16/2010
This is everybody's president by his deeds not just words.Yet every day we see those people with the hateful signs and messages of division screaming pure nonsense.So much rage and hate in their bowels..and for no good reason.Just imagine if the tables were turned and every single one of these hypocrites were prohibited from visiting their loved ones because they are straight...sounds mean and stupid doesn't it...well why is it OK to prohibit gay people from being with their loved ones.
HUFFPOST SUPER USER
cydRN
06:42 PM on 04/16/2010
As a nurse, and a person raised in a home with love and acceptance of the gay community, I applaud this memo!! It is utterly ridiculous that a loved one, regardless of orientation, is not allowed to comfort an ill or terminal patient. These rules were originally made in order to make staff jobs easier, and not for the benefit of the patients involved. Thank goodness we are moving in a patient-empowering direction.
06:38 PM on 04/16/2010
As my partner was dying, I was keenly aware that it was only through the good graces and kindness of his family that I was allowed to sit with him in his final hours. I have always been extemely grateful for that. It has also made me very aware of those who have been refused this consoling and necessary contact with loved ones because of bigotry and misunderstanding. Obama's memo gave me the chills also. Bless his heart. And bless your heart for your efforts, Matt.